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Explaining Physical Activity Maintenance After a Theory‐Based Intervention Among Patients With Rheumatoid Arthritis: Process Evaluation of a Randomized Controlled Trial

Objective Regular physical activity (PA) benefits patients with rheumatoid arthritis (RA), particularly when maintained over time. Research in this area has largely focused on factors associated with initiating PA, while factors contributing to PA maintenance, particularly after lifestyle interventi...

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Published in:Arthritis care & research (2010) 2016-02, Vol.68 (2), p.203-210
Main Authors: Knittle, Keegan, De Gucht, Véronique, Hurkmans, Emalie, Vlieland, Thea Vliet, Maes, Stan
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container_title Arthritis care & research (2010)
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De Gucht, Véronique
Hurkmans, Emalie
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description Objective Regular physical activity (PA) benefits patients with rheumatoid arthritis (RA), particularly when maintained over time. Research in this area has largely focused on factors associated with initiating PA, while factors contributing to PA maintenance, particularly after lifestyle interventions, have received less attention. This study examined whether higher levels of autonomous motivation, self‐efficacy for PA, and greater use of self‐regulation skills mediated PA initiation and maintenance 6 months after a theory‐based motivational interviewing and self‐regulation coaching intervention. Methods Seventy‐eight individuals with RA were randomized to receive either a patient‐education session (control group), or the patient‐education session plus 1 motivational interview and 2 self‐regulation coaching sessions (treatment group). Mediation analyses examined the effects of this intervention on PA initiation and maintenance through the intermediate variables autonomous motivation, self‐efficacy for PA, and use of self‐regulation skills. Analyses were controlled for age, sex, and previous levels of PA. Results The treatment group reported significantly higher autonomous motivation and greater use of self‐regulation skills than controls at posttreatment. Increases in PA from baseline to posttreatment were not mediated by any intermediate variables. However, maintenance of PA from posttreatment to followup (6 months later) was mediated by greater autonomous motivation and use of self‐regulation skills. Conclusion Greater autonomous motivation and use of self‐regulation skills predict maintenance of PA following a motivational interviewing and self‐regulation coaching intervention. In promoting PA among patients with RA, supporting patient autonomy and teaching self‐regulation skills, which focus attention on achieving PA goals, may improve long‐term maintenance of PA.
doi_str_mv 10.1002/acr.22647
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Research in this area has largely focused on factors associated with initiating PA, while factors contributing to PA maintenance, particularly after lifestyle interventions, have received less attention. This study examined whether higher levels of autonomous motivation, self‐efficacy for PA, and greater use of self‐regulation skills mediated PA initiation and maintenance 6 months after a theory‐based motivational interviewing and self‐regulation coaching intervention. Methods Seventy‐eight individuals with RA were randomized to receive either a patient‐education session (control group), or the patient‐education session plus 1 motivational interview and 2 self‐regulation coaching sessions (treatment group). Mediation analyses examined the effects of this intervention on PA initiation and maintenance through the intermediate variables autonomous motivation, self‐efficacy for PA, and use of self‐regulation skills. Analyses were controlled for age, sex, and previous levels of PA. Results The treatment group reported significantly higher autonomous motivation and greater use of self‐regulation skills than controls at posttreatment. Increases in PA from baseline to posttreatment were not mediated by any intermediate variables. However, maintenance of PA from posttreatment to followup (6 months later) was mediated by greater autonomous motivation and use of self‐regulation skills. Conclusion Greater autonomous motivation and use of self‐regulation skills predict maintenance of PA following a motivational interviewing and self‐regulation coaching intervention. In promoting PA among patients with RA, supporting patient autonomy and teaching self‐regulation skills, which focus attention on achieving PA goals, may improve long‐term maintenance of PA.</description><identifier>ISSN: 2151-464X</identifier><identifier>EISSN: 2151-4658</identifier><identifier>DOI: 10.1002/acr.22647</identifier><identifier>PMID: 26137923</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Arthritis, Rheumatoid - psychology ; Arthritis, Rheumatoid - therapy ; Exercise - psychology ; Female ; Humans ; Male ; Middle Aged ; Motivation ; Motivational Interviewing ; Patient Education as Topic ; Process Assessment (Health Care) ; Self Efficacy ; Self-Control</subject><ispartof>Arthritis care &amp; research (2010), 2016-02, Vol.68 (2), p.203-210</ispartof><rights>2016, American College of Rheumatology</rights><rights>2016, American College of Rheumatology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3937-3fb070c8dfa77b442855279fa5ed394664d5bbf47a6402a2668c33de4b328b63</citedby><cites>FETCH-LOGICAL-c3937-3fb070c8dfa77b442855279fa5ed394664d5bbf47a6402a2668c33de4b328b63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26137923$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Knittle, Keegan</creatorcontrib><creatorcontrib>De Gucht, Véronique</creatorcontrib><creatorcontrib>Hurkmans, Emalie</creatorcontrib><creatorcontrib>Vlieland, Thea Vliet</creatorcontrib><creatorcontrib>Maes, Stan</creatorcontrib><title>Explaining Physical Activity Maintenance After a Theory‐Based Intervention Among Patients With Rheumatoid Arthritis: Process Evaluation of a Randomized Controlled Trial</title><title>Arthritis care &amp; research (2010)</title><addtitle>Arthritis Care Res (Hoboken)</addtitle><description>Objective Regular physical activity (PA) benefits patients with rheumatoid arthritis (RA), particularly when maintained over time. Research in this area has largely focused on factors associated with initiating PA, while factors contributing to PA maintenance, particularly after lifestyle interventions, have received less attention. This study examined whether higher levels of autonomous motivation, self‐efficacy for PA, and greater use of self‐regulation skills mediated PA initiation and maintenance 6 months after a theory‐based motivational interviewing and self‐regulation coaching intervention. Methods Seventy‐eight individuals with RA were randomized to receive either a patient‐education session (control group), or the patient‐education session plus 1 motivational interview and 2 self‐regulation coaching sessions (treatment group). Mediation analyses examined the effects of this intervention on PA initiation and maintenance through the intermediate variables autonomous motivation, self‐efficacy for PA, and use of self‐regulation skills. Analyses were controlled for age, sex, and previous levels of PA. Results The treatment group reported significantly higher autonomous motivation and greater use of self‐regulation skills than controls at posttreatment. Increases in PA from baseline to posttreatment were not mediated by any intermediate variables. However, maintenance of PA from posttreatment to followup (6 months later) was mediated by greater autonomous motivation and use of self‐regulation skills. Conclusion Greater autonomous motivation and use of self‐regulation skills predict maintenance of PA following a motivational interviewing and self‐regulation coaching intervention. 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subjects Aged
Arthritis, Rheumatoid - psychology
Arthritis, Rheumatoid - therapy
Exercise - psychology
Female
Humans
Male
Middle Aged
Motivation
Motivational Interviewing
Patient Education as Topic
Process Assessment (Health Care)
Self Efficacy
Self-Control
title Explaining Physical Activity Maintenance After a Theory‐Based Intervention Among Patients With Rheumatoid Arthritis: Process Evaluation of a Randomized Controlled Trial
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